Ke luhi mau nei kāu keiki liʻiliʻi, he ʻili uliuli kona, a he kuni paha i nā manawa a pau? I kekahi manawa he mau hōʻailona maʻamau wale nō kēia. Akā i kekahi manawa, hiki i kēia mau mea liʻiliʻi ke lilo i hōʻailona o kahi maʻi koʻikoʻi i loko o ke kino. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano maʻi koko i maʻamau i waena o nā keiki ʻōpio, akā hiki ke hoʻopilikia i nā pākeke. ʻO kona inoa ʻo Acute Lymphoblastic Leukemia, a i ʻole (ALL) no ka pōkole. Mai hopohopo, e kamaʻilio mākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.
I ka ʻōlelo maʻalahi, he aha ke ʻano o ALL?
ʻO ka Acute Lymphoblastic Leukemia (ALL) kahi ʻano maʻi ʻaʻai e ulu ana i loko o ko kākou koko. Loaʻa i loko o ko kākou koko nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo, a me nā platelets. ʻO kekahi ʻano hunaola koko keʻokeʻo i kapa ʻia he lymphocytes. E like me ka pūʻali koa o ko kākou ʻāina, pale kēia mau hunaola iā kākou ma ke kaua ʻana i nā maʻi a me nā huakini e komo i loko o ko kākou kino.
Hoʻopuka ʻia kēia mau pūnaewele lymphocyte i loko o ka iwi iwi i loko o ko kākou mau iwi. I kekahi manawa, ma muli o kahi hoʻololi genetic i loko o kēia mau pūnaewele lymphocyte, hoʻomaka lākou e lilo i mau pūnaewele kanesa ma kahi o nā pūnaewele olakino. Māhelehele a hoʻonui koke kēia mau pūnaewele kanesa me ka ʻole o ke kaohi, e hoʻokuke ana i nā pūnaewele olakino. Ua kapa wale ʻia kēia he ALL.
ʻAʻole noho wale kēia mau hunaola kanesa i loko o ka iwi iwi. Hiki iā lākou ke hele ma ke koko a laha (metastasize) ma ke kino holoʻokoʻa.
Akā ʻo ka mea nui loa, ʻoiai he maʻi koʻikoʻi, he maʻi hiki ke ho'ōla piha ʻia me ka mālama pono ʻana. Kiʻekiʻe loa ka nui o ka ho'ōla ʻana, ʻoiai hoʻi i waena o nā keiki ʻōpio.
He aha nā ʻano nui o ALL?
Ke kamaʻilio mākou e pili ana i nā lymphocytes, aia ʻelua ʻano nui o lākou: nā pūnaewele B a me nā pūnaewele T. Hoʻomohala nā maʻi kanesa āpau mai kēia mau ʻano pūnaewele ʻelua.
| ʻAno maʻi kanesa | He wehewehe maʻalahi |
|---|---|
| ʻO ke kelepona B āpau (ʻO ke kelepona B āpau) | ʻO kēia ke ʻano maʻamau. He 85% ia o ALL i nā keiki a me 75%-80% o ALL i nā pākeke. ʻO nā pūnaewele B ke ʻano o nā pūnaewele e hana i nā antibodies e kūʻē i nā germs i loko o ko mākou kino. |
| Kelepona-T āpau (kelepona-T āpau) | He mea kākaʻikahi iki kēia. Ma kahi o 25% o nā mākua a me 12%-15% o nā keiki e loaʻa i kēia ʻano. ʻO nā pūnaewele T ke ʻano o nā pūnaewele e pepehi pololei i nā germs a kōkua i nā pūnaewele ʻē aʻe i loko o ka ʻōnaehana pale. |
Ma waho aʻe o kēia mau ʻano ʻelua, aia kekahi ʻano kakaikahi loa i kapa ʻia ʻo Natural Killer ALL. E hana kāu kauka i nā hoʻokolohua e pono ai e ʻike pono i ke ʻano āu a i ʻole kāu keiki.
He aha nā hōʻailona a mākou e ʻike nei?
Ke ulu aʻe ʻo ALL, ua pau nā hunaola koko olakino o ke kino, e hana ana i nā ʻano hōʻailona like ʻole. Hiki ke hele koke mai kēia mau hōʻailona a ulu mālie paha.
He mea nui: ʻO ka loaʻa ʻana o kēia mau hōʻailona ʻaʻole ia he manaʻo ua loaʻa iā ʻoe nā mea āpau. Eia nō naʻe, inā loaʻa iā ʻoe kēia mau hōʻailona no nā pule ʻelua a ʻoi aku, he mea nui e ʻike i ke kauka no ka ʻōlelo aʻo.
| Hōʻailona | He aha kēlā manaʻo? |
|---|---|
| Ka luhi mau a me ka maeʻele | Ma muli o ka emi ʻana o nā hunaola koko ʻulaʻula i loko o ke kino (anemia), ʻoiai ka hana ʻana i nā hana liʻiliʻi hiki ke luhi, a hiki ke ʻike ʻia ke kino he keʻokeʻo. |
| Ke maʻi pinepine nei | I ka emi ʻana o nā hunaola koko keʻokeʻo olakino, emi pū ka hiki o ke kino ke kaua aku i nā maʻi (palekana). ʻO ka hopena, hiki ke loaʻa pinepine nā maʻi e like me ke kuni a me ke anu. |
| Ke kahe koko a me ka ʻeha | I ka emi ʻana o nā platelets e kōkua ana i ke kāpili ʻana o ke koko, hiki i ke kahe ʻana o ka ihu, ke kahe ʻana o nā ʻāʻī, a me nā ʻeha liʻiliʻi ke hana i nā kiko polū nui ma ke kino. Hiki i nā wāhine ke kahe nui ke koko i ka wā o ka menstruation. |
| Nā kiko ʻulaʻula ma ka ʻili (petechiae) | ʻIke ʻia nā kiko ʻulaʻula liʻiliʻi ma ka ʻili me he mea lā ua hou ʻia i kahi pine, ma muli o ke kahe ʻana o ke koko mai nā kīʻaha koko lahilahi loa ma lalo o ka ʻili. |
| ʻEha iwi a me nā hono | I ka hoʻopiha ʻana o nā hunaola kanesa i ka iwi ʻiʻo, hiki ke loaʻa ka ʻeha nui ma nā iwi a me nā hono. |
| Nā ʻōpū lymph pehu | Hiki i nā puʻupuʻu (nodules) ma nā wahi e like me ka ʻāʻī, nā armpits, a me ka ʻūhā ke pehu me ka ʻole o ka ʻeha. |
| Nā hiʻohiʻona ʻē aʻe | Hiki ke ʻike ʻia nā hōʻailona e like me ka nalowale o ka makemake e ʻai, ka pohō kaumaha, ka hou ʻana o ka pō, a me ka paʻakikī o ka hanu ʻana. |
No ke aha e loaʻa ai kēia maʻi? He aha nā kumu pilikia?
ʻAʻohe kumu kikoʻī hoʻokahi o nā maʻi kanesa āpau. ʻO ke kumu nui, e like me kā mākou i kūkākūkā ai ma mua, ʻo ia nā hoʻololi genetic e kū mai ana i ka wā o ke kūkulu ʻia ʻana o nā hunaola koko. I nā keiki ʻōpio, hiki ke hana ʻia kēia mau hoʻololi ma mua o ko lākou hānau ʻana.
Eia nō naʻe, ua ʻike ʻia kekahi mau kumu e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i kēia maʻi.
- Makahiki: ʻOi aku ka nui o ka pilikia ma waena o nā keiki ma lalo o 15 mau makahiki, ʻoi aku hoʻi ka poʻe ma waena o 2-5 mau makahiki, a me nā pākeke ma luna o 50 mau makahiki.
- ʻO kekahi mau maʻi genetic: ʻO ka poʻe me kekahi mau maʻi genetic, e like me Down syndrome, he kiʻekiʻe iki ka pilikia o ka hoʻomohala ʻana iā ALL.
- Ka ʻike ʻia ʻana i ka radiation: ʻO ka ʻike ʻia ʻana i nā pae kiʻekiʻe o ka radiation, no ka laʻana, inā ua loaʻa iā ʻoe ka radiation therapy no kekahi maʻi ʻē aʻe, hiki ke hoʻonui i kou pilikia.
- Kekahi mau maʻi: Manaʻo ʻia kekahi mau maʻi viral, e like me ka maʻi Epstein-Barr, e hoʻonui i ka pilikia.
- Ka hoʻohana ʻana i ka paka: Ma waena o nā pākeke, ʻo ka ʻike ʻana i nā carcinogens e like me ka hoʻohana ʻana i ka paka kekahi kumu.
Pehea e ʻike pololei ai ke kauka i kēia maʻi?
Ke hele ʻoe e ʻike i ke kauka me nā hōʻailona āu i ʻōlelo ai ma luna, e nīnau mua ʻo ia iā ʻoe i kahi nīnau kikoʻī e pili ana i kāu mau hōʻailona. A laila e hana ʻo ia i kahi hoʻokolokolo kino a kauoha i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.
- Nā hoʻāʻo koko:Hiki i kahi hoʻāʻo Full Blood Count (FBC) maʻamau ke ʻike i nā ʻano ʻē i ka helu o nā cell i loko o ke koko.
- ʻO ka biopsy iwi iwi: ʻO kēia ka hoʻāʻo nui i hoʻohana ʻia e hōʻoia i ka hōʻailona. Lawe ʻia kahi hāpana liʻiliʻi o ka iwi iwi mai kahi wahi e like me ka iwi ʻūhā ma lalo o ka anesthesia a nānā ʻia ma lalo o kahi microscope. Hiki i kēia ke hoʻoholo pololei inā loaʻa nā hunaola kanesa a, inā pēlā, he aha ke ʻano.
- Nā hoʻāʻo kiʻi: Hiki ke hana ʻia nā scan CT a me nā scan PET e ʻike ai inā ua pālahalaha ke kanesa i nā ʻāpana ʻē aʻe o ke kino, no ka laʻana, i ka lua o ka umauma.
- ʻO ke kī ʻana o ka iwi kuamoʻo/ʻO ke kī ʻana o ka iwi kuamoʻo: Inā he kānalua ua pālahalaha nā hunaola kanesa i ka lolo a i ʻole ke kaula iwi kuamoʻo, e lawe ʻia kahi wai liʻiliʻi o ka iwi kuamoʻo mai ka iwi kuamoʻo a hoʻāʻo ʻia.
He aha nā lāʻau lapaʻau no ALL?
Aia kekahi mau lāʻau lapaʻau no ALL. Na kāu kauka e hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa nāu ma muli o nā kumu he nui, me kou makahiki, ke ʻano o ka maʻi, a me nā māka genetic i loko o kāu mau cell cancer.
Lapaʻau nui: Chemotherapy
He lāʻau ikaika ka Chemotherapy e pepehi ana i nā hunaola kanesa. ʻO ia ka lāʻau lapaʻau nui no ALL. Hāʻawi ʻia kēia lāʻau lapaʻau i kekahi mau pae, e mau ana mai kekahi mau mahina a i ʻelua a ʻekolu mau makahiki.
| Nā pae lapaʻau | He aha ka mea e hana nei? |
|---|---|
| 1. Ka pae mua (Remission Induction) | He 4-6 pule ka lōʻihi o kēia. ʻO ka pahuhopu nui ka luku ʻana i nā hunaola kanesa he nui i ka hikiwawe loa. I loko o kēia manawa, pono pinepine ʻoe e noho i ka haukapila. |
| 2. Ka mālama ʻana i ka ʻōnaehana nerve (lāʻau lapaʻau i kuhikuhi ʻia e CNS) | Hāʻawi ʻia kēia lāʻau lapaʻau e pale aku i nā hunaola kanesa mai ka laha ʻana i ka lolo a me ke kaula kuamoʻo, a i ʻole e luku iā lākou inā ua laha lākou. Hana pinepine ʻia kēia i ka pae mua. |
| 3. Ka pae hoʻohui | Ma hope o ka hoʻomaha ʻana o ka maʻi, hoʻomaka kēia pae e luku i nā hunaola kanesa i koe. E hoʻopaʻa ʻia ʻoe i ka haukapila no kekahi mau lā i kēlā me kēia mau pule no kekahi mau mahina a loaʻa iā ʻoe nā lāʻau lapaʻau intravenous (IV). |
| 4. Ka pae mālama | ʻO kēia ke kahua hope loa a lōʻihi loa. He 2-3 mau makahiki ka lōʻihi. ʻO ka pahuhopu ma ʻaneʻi, ʻo ia ke pale ʻana i ka hoʻi hou ʻana mai o ka maʻi. ʻO ka hapa pinepine, hāʻawi ʻia nā lāʻau lapaʻau waha a me nā lāʻau lapaʻau intravenous ma ke keʻena lapaʻau. ʻAʻohe pono e hele pinepine i ka haukapila. |
Nā lāʻau lapaʻau ʻē aʻe
- Lapaʻau i kuhikuhi ʻia: Pili kēia i ka hāʻawi ʻana i nā lāʻau lapaʻau e hoʻouka i nā loli genetic kikoʻī i loaʻa wale i nā cell cancer. No ka laʻana, he kūpono loa kēia lāʻau lapaʻau i nā poʻe me kahi loli genetic i kapa ʻia ʻo ka chromosome Philadelphia.
- Immunotherapy: Pili kēia i ka hoʻoulu ʻana i kā mākou ʻōnaehana pale ponoʻī e luku i nā hunaola maʻi kanesa. ʻO ka CAR-T cell therapy kahi ʻano lapaʻau hou e hāʻule ana ma lalo o kēia māhele.
- Lapaʻau radiation: Hiki ke hoʻohana ʻia ka lāʻau radiation i nā hihia kahi i pane ʻole ai ke kanesa i ka chemotherapy a i ʻole ke hoʻi hou mai ka maʻi.
- Hoʻoili iwi iwi: Inā ʻaʻole holomua nā lāʻau ʻē aʻe a i ʻole kiʻekiʻe loa ka pilikia o ka hoʻi ʻana mai o ka maʻi, hiki ke kuhikuhi ʻia ʻoe no kahi hoʻoili iwi iwi mai kahi kanaka olakino.
He aha nā manawa kūpono e ho'ōla ai i kēia maʻi?
ʻO kēia ka nīnau nui loa ma ka noʻonoʻo o kēlā me kēia kanaka. He maʻi ʻaʻai ʻo ALL e pane maikaʻi loa ana i ka lāʻau lapaʻau.
I nā keiki, he mea hoʻohiki maikaʻi loa nā hopena. 98% o nā keiki i loaʻa ka lāʻau kūpono e hoʻopau piha i ka maʻi. ʻO ka nui o ke ola ma hope o 5 mau makahiki ma hope o ka hoʻōla ʻia ʻana o ka maʻi he 90%.
He haʻahaʻa iki kēia pakeneka i waena o nā pākeke. ʻO ka helu ola 5 makahiki no nā pākeke ma waena o 30% - 40%.
Akā, he mea nui e hoʻomaopopo he mau helu wale nō kēia. Hiki ke ʻokoʻa loa ke ʻano o ka pane ʻana o kekahi i ka lāʻau lapaʻau mai kekahi. No laila, mai hopohopo i kēia mau helu. ʻO ke kauka wale nō e mālama iā ʻoe ke hāʻawi iā ʻoe i ka ʻike maikaʻi loa e pili ana i ke kūlana o kāu keiki.
He mea maʻamau ka manaʻo e like me ka hiolo ʻana o kou ola ke ʻike ʻia ʻoe he maʻi kanesa. ʻOi loa aku inā ʻo kāu keiki ia. Akā e hoʻomanaʻo, ʻoi aku ka maʻi hiki ke ho'ōla ʻia ma mua o nā ʻano maʻi kanesa ʻē aʻe. E hilinaʻi i kāu hui lapaʻau. E noho pū lākou me ʻoe ma kēia huakaʻi, e hāʻawi ana iā ʻoe i ke kākoʻo a me nā wehewehe āpau āu e pono ai.
Leka Lawe-Home
- ʻO ka Acute Lymphoblastic Leukemia (ALL) kahi maʻi ʻaʻai e ulu ana i loko o nā lymphocytes, kahi ʻano keʻokeʻo koko.
- ʻOiai ʻo kēia maʻi ka mea maʻamau i waena o nā keiki ʻōpio, hiki iā ia ke ulu i loko o kekahi o nā makahiki āpau.
- Inā ʻike ʻoe i nā hōʻailona e like me ka luhi mau, ka maeʻele, ka maʻi pinepine, ka uliuli o ke kino, a me ka ʻeha o ka iwi no nā pule ʻelua a ʻoi, e ʻimi koke i ke kōkua lapaʻau.
- ʻOiai he maʻi koʻikoʻi ʻo ALL, hiki ke ho'ōla piha ʻia me nā lāʻau lapaʻau e like me ka chemotherapy. He kiʻekiʻe loa ka nui o ka ho'ōla ʻana, ʻoiai hoʻi i waena o nā keiki.
- Hiki ke lōʻihi a luhi ke kaʻina hana lapaʻau, akā mai makaʻu iā ia, e hilinaʻi i kāu mau kauka, a e hahai pololei i kā lākou mau kuhikuhi.
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